Research Article

Sentinel node biopsy in squamous cell cancer of the oral cavity and oral pharynx: A diagnostic meta-analysis†

  1. Vinidh Paleri MS FRCS (ORL-HNS)1,*,
  2. Guy Rees FRCS (ORL-HNS)2,
  3. Puveendran Arullendran FRCS (ORL-HNS)3,
  4. Taimur Shoaib FRCSED (Plast)4,
  5. Suren Krishman FRACS2

Article first published online: 26 JUL 2005

DOI: 10.1002/hed.20228

Issue

Head & Neck

Head & Neck

Volume 27, Issue 9, pages 739–747, September 2005

Additional Information

How to Cite

Paleri, V., Rees, G., Arullendran, P., Shoaib, T. and Krishman, S. (2005), Sentinel node biopsy in squamous cell cancer of the oral cavity and oral pharynx: A diagnostic meta-analysis. Head Neck, 27: 739–747. doi: 10.1002/hed.20228

Author Information

  1. 1

    Otolaryngology-Head-Neck Surgery, Freeman Hospital, Newcastle upon Tyne

  2. 2

    Otolaryngology-Head-Neck Surgery, Royal Adelaide Hospital, Adelaide, England

  3. 3

    Otolaryngology-Head-Neck Surgery, Sunderland Royal Hospital, Sunderland, England

  4. 4

    Canniesburn Plastic Surgery Unit, Royal Infirmary, Glasgow, Scotland

*21 Greenlee Drive, Little Benton, Newcastle upon Tyne NE7 7GA, England

  1. †

    Presented at the 7th EBM day on Neck Lumps at the National Otolaryngology Trials Office, November 2003, Newcastle upon Tyne, United Kingdom

Publication History

  1. Issue published online: 16 AUG 2005
  2. Article first published online: 26 JUL 2005
  3. Manuscript Accepted: 7 MAR 2005

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Keywords:

  • sentinel lymph node biopsy;
  • head and neck cancer;
  • meta-analysis;
  • systematic review;
  • decision support techniques

Abstract

Background.

The sentinel node biopsy concept has been gaining support in the head and neck cancer literature during only the last few years, and several pilot studies have been published. This procedure aims to avoid unnecessary treatment to the clinically negative neck by identifying the patients with occult neck disease.

Methods.

We performed a systematic review and a diagnostic meta-analysis of all published literature regarding sentinel node biopsies in head and neck cancer until December 2003 using established guidelines. Using the pooled sensitivity rates obtained from the meta-analysis and treatment outcomes from published literature, we created a decision analysis model to identify the treatment arm with better payoffs.

Results.

A total of 301 patients with oral cavity primary tumors and 46 patients with oropharyngeal primary tumors from 19 articles were included for the meta-analysis. The pooled sensitivity result using the random effects model was 0.926 (95% confidence interval, 0.852–0.964). The cumulative payoff for the sentinel node biopsy arm was lower than that for the elective node dissection arm by about 1%. The payoffs were assigned for the recurrence and mortality rates only and did not take into account the morbidity caused by the procedures.

Conclusions.

The sentinel node biopsy procedure has shown high sensitivity rates in pilot studies for oral and oropharyngeal squamous cell cancer across the globe and is reliable and reproducible. This study provides a firm evidence base for forthcoming trials on the role of sentinel node biopsy in head and neck cancer. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX–XXX, 2005

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